Chen Y C, Chang S C, Hsieh W C, Luh K T
Department of Internal Medicine, National Taiwan University Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1991 Oct;90(10):958-63.
The medical records of 48 patients with Acinetobacter calcoaceticus bacteremia over a recent two-year period were reviewed retrospectively to determine the epidemiologic and clinical features. There were 34 males and 14 females with a median age of 51 years. Forty-six of the cases were hospital-acquired. The characteristics of these patients included residence in the intensive care unit, intubation and ventilatory support, preceding antibiotic therapy and intravascular catheterization. In vitro susceptibility testing for the isolated organisms revealed that 32% of these strains were resistant to gentamicin and 90% were aztreonam-resistant. Minocycline, amikacin, ceftazidime, ticarcillin, imipenem, and the new quinolones retained good activity. Although A. calcoaceticus causes septic pictures as do other aerobic Gram-negative bacilli and part of these isolates are multiple drug-resistant, the infection did not seem to be difficult to control. Twenty-six (54%) of these patients survived, including 9 patients without appropriate antimicrobial therapy initiated within 48 hours of blood sampling. The mortality was rarely due to bacteremia per se; most often, it resulted from the underlying diseases.
回顾性分析了近两年来48例醋酸钙不动杆菌菌血症患者的病历，以确定其流行病学和临床特征。患者中男性34例，女性14例，中位年龄51岁。46例为医院获得性感染。这些患者的特点包括入住重症监护病房、插管和通气支持、先前的抗生素治疗以及血管内导管插入术。对分离出的菌株进行的体外药敏试验显示，这些菌株中有32%对庆大霉素耐药，90%对氨曲南耐药。米诺环素、阿米卡星、头孢他啶、替卡西林、亚胺培南和新型喹诺酮类药物仍具有良好的活性。尽管醋酸钙不动杆菌与其他需氧革兰氏阴性杆菌一样会引起败血症，且部分分离株对多种药物耐药，但感染似乎并不难控制。这些患者中有26例（54%）存活，其中包括9例在采血后48小时内未开始进行适当抗菌治疗的患者。死亡率很少是由菌血症本身导致的；大多数情况下，是由基础疾病引起的。
